Dermatologic surgery has become more common in various clinics and hospitals because of the many factors discussed in previous chapters. Many small and large hospitals are taking interest in having this surgical service on their premises. They are ready to invest in equipment required to deliver the best results. There is an ever-increasing awareness among the general population regarding their skin lesions. Many seek advice for removal of their skin lesions either as treatment or to improve their appearance (for cosmetic purposes). Consultation for removal of unsightly skin lesions on the face or elsewhere has become extremely common.
In dermatologic surgery practice, most of the patients are not ill or unhealthy. These patients approach doctors for either one or more of the following needs:
The lesions are very unsightly and spoiling their looks. These lesions include moles, keratosis, milia, ear keloids, keratoacanthoma, xanthelasma, syringoma, sebaceous cysts, and pyogenic granuloma.
There is some kind of skin infection (e.g., verruca vulgaris, molluscum contagiosum, and condyloma acuminatum).
The lesions are painful or cause discomfort in mobility, such as an infected skin tag or papilloma, corn, or callus.
The lesions spoil facial appearance due to dotted hyperpigmented spots, as in freckles.
Acne scars or deep crateriform scars.
After hearing from some friends or knowing from media that such things can be easily done these days.
Wish to look good by removing unsightly looking dermatosis papulosa nigra, senile comedones, syringoma, or capillary hemangioma.
Senior citizens wishing to get rid of their skin tags or senile comedones on demand of their grandchildren or because they can afford to now.
Wishing to spend on removing skin lesions on face in spite of nonaffordability only for cosmetic purpose.
Referred to dermatologic surgery department from other doctors for removing skin lesions instead of to department of surgery.
Need to do skin biopsy.
All the aforementioned indications, barring a few, were very commonly treated by general surgeons or otorhinolaryngologists or ophthalmologists when dermatologic surgery was not a specialty of its own. Today, due to a high following and superior techniques of dermatologic surgery, there is reverse flow, which has led the aforementioned specialties to learn from dermatologists.
The previous chapter dealt with all the available modalities for dermatologic surgery. When one considers the features marking the advantages and disadvantages of each modality, only one modality outsmarts all others, namely, radiofrequency surgery. It is hoped that the features of Table 5.1 will convince the reader of the advantages of radiofrequency surgery.